Therapeutic Injections in the Context of Egyptian Culture

Lohiniva, Anna-Leena; Talaat, Maha; Bodenschatz, Caroline; Kandeel, Amr; El‐Adawy, Maha; Earhart, Kenneth C.; Mahoney, Frank

doi:10.1177/175797590501200102

Cited by 6 publications

(4 citation statements)

References 16 publications

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“…Oral therapies for schistosomiasis were gradually adopted in the 1980's, dramatically reducing transmission. 16,62 It is still unclear, however, what the rate of HCV transmission is presently, in the absence of the original primary route. Since several of the childhood HCV studies were late enough that none of the children would have been exposed to the PAT campaign, it does appear that HCV has continued to be transmitted.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of hepatitis viruses among hepatocellular carcinoma cases and healthy people in Egypt: A systematic review and meta‐analysis

Lehman

Wilson

2008

Intl Journal of Cancer

127

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Liver cancers are strongly linked to hepatitis B virus (HBV) and hepatitis C virus (HCV). Egypt has the highest prevalence of HCV worldwide and has rising rates of hepatocellular carcinoma (HCC). Egypt's unique nature of liver disease presents questions regarding the distribution of HBV and HCV in the etiology of HCC. Accordingly, a systematic search of MEDLINE, ISI Web of Science, ScienceDirect and World Health Organisation databases was undertaken for relevant articles regarding HBV and HCV prevalence in Egypt among healthy populations and HCC cases. We calculated weighted mean prevalences for HBV and HCV among the populations of interest and examined differences in prevalence by descriptive features, including age, year and geographic region. Prevalences for HBV and HCV were 6.7% and 13.9% among healthy populations, and 25.9% and 78.5% among HCC cases. Adults had higher prevalences of both infections (Adult HBV 5 8.0%, Child HBV 5 1.6%; Adult HCV 5 15.7%, Child HCV 5 4.0%). Geographically, HBV was higher in the south, whereas HCV was greater in the north (North HBV 5 4.6%, South HBV 5 11.7%; North HCV 5 15.8%, South HCV 5 6.7%). Among HCC cases, HBV significantly decreased over time (p 5 0.001) while HCV did not, suggesting a shift in the relative influences of these viruses in HCC etiology in Egypt. Our results highlight large amounts of heterogeneity among the epidemiological factors associated with liver disease in Egypt and underscore the necessity of an integrated strategy for the successful prevention of viral hepatitis infections and chronic liver disease. ' 2008 Wiley-Liss, Inc.Key words: pooled analysis; liver cancer; infectious diseases; developing countries Hepatocellular carcinoma (HCC) comprises nearly 6% of all incident cancer cases worldwide, with the overwhelming majority occurring in the developing world.1 One of the least curable malignancies, HCC is the third most frequent cause of cancer mortality among men worldwide.1 Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) have been cited as, by far, the most important etiologic agents.2 According to the World Health Organisation (WHO), 350 million people are chronically infected with HBV and 170 million are infected with HCV.3,4 The relative importance of HBV and HCV as causative agents can vary greatly from region to region and over time.1,5 Selecting appropriate HCC prevention and control methods, therefore, depends on understanding the dynamics of these agents in a specified geographic region.Incidence of HCC in Egypt is currently increasing, which may be the result of a shift in the relative importance of HBV and HCV as primary risk factors.6-8 HCC is the second most frequent cause of cancer incidence and mortality among men in Egypt.9 Hospitalbased studies from Egypt have reported an increase in the relative frequency of all liver-related cancers in Egypt (>95% as HCC), from 4.0% in 1993 to 7.3% in 2003.6-8 The Middle East Cancer Consortium recently reported that the incidence rate among males was 7 times greater...

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Section: Discussionmentioning

confidence: 99%

Epidemiology of hepatitis viruses among hepatocellular carcinoma cases and healthy people in Egypt: A systematic review and meta‐analysis

Lehman

Wilson

2008

Intl Journal of Cancer

127

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“…Efforts to address this issue in many developing countries including Egypt are underway but the costs associated with the procurement and proper disposal of single use syringes and other disposable devices pose an obstacle. In addition, overuse of injections will likely remain widespread for reasons that include economic incentives for providers and patient beliefs that injections are the best form of treatment for many common conditions [10]. Transmission of HCV and other viruses from unscreened blood used for transfusions also remains a worldwide concern [9].…”

Section: See Article Pages 455-461mentioning

confidence: 99%

The coming wave of HCV-related liver disease: Dilemmas and challenges

Perz

Alter

2006

Journal of Hepatology

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“…Occupational transmission among healthcare workers through needle sticks and injuries from sharp objects contributes to new HCV cases because needle stick‐prevention devices have not yet been adopted by most hospitals and healthcare units. Inadequate compliance to universal, standard precautions in some health facilities also remains an issue (57–59). Low prevalence rates of IVDU are reported in Egypt.…”

Section: Epidemiologymentioning

confidence: 99%

The neglected hepatitis C virus genotypes 4, 5 and 6: an international consensus report

Antaki

Craxı̀

Kamal

et al. 2010

Liver International

155

118

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Hepatitis C virus (HCV) genotypes 4, 5 and 6 represent >20% of all HCV cases worldwide. HCV‐4 is mainly seen in Egypt, where it represents 90% of all HCV cases. Antischistosomal therapy was the main cause of contamination there, followed by procedures performed by informal providers and traditional healers such as dental care, wound treatment, circumcision, deliveries, excision and scarification. It is also highly prevalent in sub‐Saharan Africa and in the Middle East. In Europe, its prevalence has recently increased particularly among intravenous drug users and in immigrants. HCV‐5 is mainly found in South Africa, where it represents 40% of all HCV genotypes, but four pockets of HCV‐5 were found in France, Spain, Syria and Belgium and sporadic cases were found elsewhere. The mode of transmission is mainly iatrogenic and transfusion. HCV‐6 is found in Hong Kong, Vietnam, Thailand and Myanmar and also in American and Australian from Asian origin. The response to treatment in HCV‐4 is intermediate between HCV‐1 and HCV‐2 and HCV‐3. A sustained viral response is achieved in 43–70% with pegylated interferon and ribavirin. It is higher in Egyptians than Europeans and Africans and is negatively related to insulin resistance and to the severity of fibrosis. It increases to >80% with 24 weeks of therapy only if a rapid virological response is achieved. In HCV‐5, a sustained virological response is achieved in >60% with 48 weeks of therapy. HCV‐6 is also considered an easy‐to‐treat genotype, leading to a response in 60–85% of cases.

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Therapeutic Injections in the Context of Egyptian Culture

Cited by 6 publications

References 16 publications

Epidemiology of hepatitis viruses among hepatocellular carcinoma cases and healthy people in Egypt: A systematic review and meta‐analysis

Epidemiology of hepatitis viruses among hepatocellular carcinoma cases and healthy people in Egypt: A systematic review and meta‐analysis

The coming wave of HCV-related liver disease: Dilemmas and challenges

The neglected hepatitis C virus genotypes 4, 5 and 6: an international consensus report

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